Antarctica\u27s \u27moss forests\u27 are drying and dying

The lush moss beds that grow near East Antarctica\u27s coast are among the only plants that can withstand life on the frozen continent. But our new research shows that these slow-growing plants are changing at a far faster rate than anticipated

Emergency Department Visits for Sexual Assault by Emerging Adults: Is Alcohol a Factor?

Introduction: Emerging adults (18-25 years of age) are at increased risk for sexual assault. There is little Emergency Department (ED) data on sexual assaults that involve alcohol among this population. The purpose of this study was to analyze ED visits for sexual assault and determine if alcohol consumption by the patient was noted. Methods: This study was a retrospective chart review of patients aged 18-25 presenting to an ED in a college town over a four-year period. Extracted variables included age, gender, delay in seeking care, sexual assault nurse examiner (SANE) evaluation, and alcohol consumption by the patient. For analysis of alcohol use, cases were categorized as ages \u3c 21 and ≥ 21. Results: There were 118 patients who presented to the ED from 2012 to 2015. The mean age of the cohort was 20 years, and almost 70% of visits were among those \u3c 21. Of those aged \u3c 21, 74% reported alcohol consumption, in contrast to 48% of those ≥ 21 (p = 0.055). Of those reporting alcohol use, 36% were evaluated on the day of the assault compared to 61% of those not reporting alcohol (p=0.035). Conclusion: This study found that ED visits for sexual assault in emerging adults were more common in younger patients. Alcohol use occurred more frequently with patients under the legal drinking age, and presentation was also more likely to be delayed. The relationship between sexual assault and alcohol use should underscore primary prevention efforts in emerging adult populations. [West J Emerg Med. 2018;19(5)797-802.

Emergency Department Visits for Sexual Assault by Emerging Adults: Is Alcohol a Factor?

Introduction: Emerging adults (18-25 years of age) are at increased risk for sexual assault. There is little Emergency Department (ED) data on sexual assaults that involve alcohol among this population. The purpose of this study was to analyze ED visits for sexual assault and determine if alcohol consumption by the patient was noted. Methods: This study was a retrospective chart review of patients aged 18-25 presenting to an ED in a college town over a four-year period. Extracted variables included age, gender, delay in seeking care, sexual assault nurse examiner (SANE) evaluation, and alcohol consumption by the patient. For analysis of alcohol use, cases were categorized as ages \u3c 21 and ≥ 21. Results: There were 118 patients who presented to the ED from 2012 to 2015. The mean age of the cohort was 20 years, and almost 70% of visits were among those \u3c 21. Of those aged \u3c 21, 74% reported alcohol consumption, in contrast to 48% of those ≥ 21 (p = 0.055). Of those reporting alcohol use, 36% were evaluated on the day of the assault compared to 61% of those not reporting alcohol (p=0.035). Conclusion: This study found that ED visits for sexual assault in emerging adults were more common in younger patients. Alcohol use occurred more frequently with patients under the legal drinking age, and presentation was also more likely to be delayed. The relationship between sexual assault and alcohol use should underscore primary prevention efforts in emerging adult populations. [West J Emerg Med. 2018;19(5)797-802.

Implementation of a Collaborative HIV and Hepatitis C Screening Program in Appalachian Urgent Care Settings

Introduction: With the current hepatitis C (HCV) epidemic in the Appalachian region and the risk of human immunodeficiency virus (HIV) co-infection, there is a need for increased secondary prevention efforts. The purpose of this study was to implement routine HIV and HCV screenings in the urgent care setting through the use of an electronic medical record (EMR) to increase a provider’s likelihood of testing eligible patients. Methods: From June 2017 through May 2018, EMR-based HIV and HCV screenings were implemented in three emergency department-affiliated urgent care settings: a local urgent care walk-in clinic; a university-based student health services center; and an urgent care setting located within a multi-specialty clinic. EMR best practice alerts (BPA) were developed based on Centers for Disease Control and Prevention (CDC) guidelines and populated on registered patients who qualified to receive HIV and/or HCV testing. Patients were excluded from the study if they chose to opt out from testing or the provider deemed it clinically inappropriate. Upon notification of a positive HIV and/or HCV test result through the EMR, patient navigators (PNs) were responsible for linking patients to their first medical appointment. Results: From June 2017 through May 2018, 48,531 patients presented to the three urgent care clinics. Out of 27,230 eligible patients, 1,972 patients (7.2%) agreed to be screened for HIV; for HCV, out of 6,509 eligible patients, 1,895 (29.1%) agreed to be screened. Thirty-one patients (1.6%) screened antibody-positive for HCV, with three being ribonucleic acid confirmed positives. No patients in either setting were confirmed positive for HIV; however, two initially screened HIV- positive. PNs were able to link 17 HCV antibody-positive patients (55%) to their first appointment, with the remainder having a scheduled future appointment. Conclusion: Introducing an EMR-based screening program is an effective method to identify and screen eligible patients for HIV and HCV in Appalachian urgent care settings where universal screenings are not routinely implemented. [West J Emerg Med. 2018;19(6)1057–1064.

Diatom communities differ among Antarctic moss and lichen vegetation types

Continental Antarctica is a polar desert containing sparse pockets of vegetation within ice-free areas. Despite the recognized association between lichens, mosses and epiphytic diatoms, the environmental factors controlling diatom community structure are poorly understood. We investigated the association between diatom communities and host vegetation characteristics by experimentally adding nutrients and/or water to two bryophyte (healthy and moribund) and two lichen (crustose and Usnea) vegetation types in the Windmill Islands. Diatom communities were morphologically characterized, diversity indices calculated and differences between treatments, vegetation type and vegetation characteristics tested. We identified 49 diatom taxa, 8 of which occurred with \u3e 1% relative abundance. Bryophyte and lichen vegetation harboured significantly different diatom communities, both in composition and diversity indices. Specifically, Luticola muticopsis was more prevalent in moribund bryophytes and crustose lichens, and Usnea lichens showed lower species richness than other types. While nutrient and water additions did not significantly alter diatom communities, diversity indices and some species showed relationships with vegetation physiological characteristics, notably %N and δ13C, suggesting the importance of ambient gradients in water and nutrient availability. Collectively, this work suggests that future conditions favouring the dominance of a particular vegetation type may have a homogenizing effect on the terrestrial diatom communities of East Antarctica

Mapping water content in drying Antarctic moss communities using UAS-borne SWIR imaging spectroscopy

Antarctic moss beds are sensitive to climatic conditions, and both their survival and community composition are particularly influenced by the availability of liquid water over summer. As Antarctic regions increasingly face climate pressures (e.g., changing hydrology and heat waves), advancing capabilities to efficiently and non-destructively monitor water content in moss communities becomes a key research priority. Because of the complexity induced by multiple micro-climatic drivers and its fragility, tracking the evolution and responses of moss bed moisture requires monitoring methods that are non-intrusive, efficient, and spatially significant, such as the use of unoccupied aerial systems (UAS). In this study, we combine a multi-species drying laboratory experiment with short-wave infrared (SWIR) spectroscopy analyses to first develop a Random Forest regression Model (RFM) capable of predicting Antarctic moss turf water content (~5% error). The RFM was then applied to UAS-borne SWIR imaging data (900–1700 nm, resolution) of the moss beds at high spatial resolution (2 cm) across three sites in the vicinity of Casey Station, Antarctica. The sites differed in terrain, snow cover, and moisture availability to evaluate method capabilities under different conditions. Optimum RFM parameters and input variables (spectral indices and reflectance spectra) were determined. Maps of moss moisture were validated via acquiring moss spectra and water content (using sponges inserted into the moss turf) collected in situ, for which an exponential correlation (R2 = 0.72) was reported. RFM further allowed investigation of the influential spectral variables to model water content in moss and associated spectral water absorption features. We demonstrated that UAS-borne SWIR imaging is a promising new tool to map and quantify water content in Antarctic moss beds. Hyperspectral mapping facilitates the exploration of the spatial variability of moss health and enables the creation of a baseline against which changes in these moss communities can be measured

Moss species on the move in East Antarctic terrestrial communities

Antarctica has experienced major changes in temperature, wind speed and stratospheric ozone levels over the last 50 years. Whilst West Antarctica and the peninsula showed rapid warming and associated ecosystem change, East Antarctica appeared to be little impacted by climate warming, thus biological changes were predicted to be relatively slow. Detecting the biological effects of Antarctic climate change has also been hindered by the paucity of long-term data sets, particularly for organisms that have been exposed to these changes throughout their lives. We monitored vegetation communities in the Windmill Islands, East Antarctica from 2000 to 2014 and found significant changes in moss species composition. In addition, we have shown that radiocarbon signals preserved along shoots of the dominant Antarctic moss flora can be used to determine accurate growth rates over a period of several decades, allowing us to explore the influence of environmental variables on growth. Carbon stable isotopic measurements suggest that the observed effects of climate variation on growth are mediated through changes in water availability and most likely linked to the more positive phase of the Southern Annular Mode and changing westerly wind patterns. For cold remote locations like Antarctica, where climate records are limited and of relatively short duration, this illustrates that mosses can act as microclimate proxies and have the potential to increase our knowledge of coastal Antarctic climate change

A Unique Resource Mutualism between the Giant Bornean Pitcher Plant, Nepenthes rajah, and Members of a Small Mammal Community

The carnivorous pitcher plant genus Nepenthes grows in nutrient-deficient substrates and produce jug-shaped leaf organs (pitchers) that trap arthropods as a source of N and P. A number of Bornean Nepenthes demonstrate novel nutrient acquisition strategies. Notably, three giant montane species are engaged in a mutualistic association with the mountain treeshrew, Tupaia montana, in which the treeshrew defecates into the pitchers while visiting them to feed on nectar secretions on the pitchers' lids

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy